Author: Gary Jackson

Use of medication to treat depression in people with opioid dependence

Blanchard (2000) studied 872 methadone-treated patients and examined the presence of axis I and II disorders. He demonstrated that if an opioid addict had one of the first axis disorders, would need the drug addiction therapies, and psychotherapy, combined with methadone maintenance treatment (MMT) 10. The results of this study show that the prevalence of depression among addicts is high, which indicates the impacts of addiction on all aspects of addicts’ lives. Therefore, it is necessary to intervene in lifestyle changes, offer regular control of depression in people to prevent the disorder, and reduce its complications. Drug addiction and opioids misuse are among some of the key challenges and concerns of contemporary societies; they are even considered as the fourth major societal challenges after nuclear issues, population increase, and environmental pollution 1. The addiction phenomenon initially reflects an image of a risky individual problem, while it is a social, economic, health, and security concern in different countries 2.

Patient resources

Pregnant women in methadone treatment programs are reported to have improved fetal outcomes compared to pregnant women using illegal drugs. A baby’s growth in the uterus, birth weight, length, and/or head circumference may be decreased in infants born to mothers treated with methadone during pregnancy. Growth deficits do not appear to last; however, decreased performance on behavioral tests have been found to continue into childhood.

Tell your doctor right away if you think you are pregnant or if you plan to become pregnant while using this medicine. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems. If you are taking this medicine for opioid use disorder and miss a dose, take your next dose the following day as scheduled. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of methadone in the elderly. However, elderly patients are more likely to have age-related heart, kidney, liver, or lung problems, which may require caution and an adjustment in the dose for patients receiving methadone.

Interactions

Serious, life-threatening, or fatal respiratory depression may occur with use of methadone hydrochloride tablets. In order to investigate the effect of heterogeneity factors, meta-regression test was used to determine which factor has the greatest impact on the values of meta-analysis. The two factors of ‘sample size’ and ‘year of publication’ were considered in the meta-regression. Results showed that with increasing sample size, mean depression scores increased, whilst mean depression decreased with increasing year of study before intervention (Figs. 6 and 7). Moreover, the mean depression scores increased with increasing sample size, and the mean depression score decreased with increasing years of study after the intervention (Figs. 8 and 9).

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Check with your doctor right away if you have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting. This medicine may cause sleep-related breathing problems (eg, sleep apnea, sleep-related hypoxemia). Your doctor may decrease your dose if you have sleep apnea (stop breathing for short periods during sleep) while using this medicine.

Symptoms of overdose

Depression is characterized by symptoms such as helplessness and hinders the cessation of addiction and the use of available coping resources. However, the results of some studies suggest that treatment of addiction-related mood disorders may decrease the onset and recurrence 35. Randomised and controlled clinical trials examining the efficacy of any antidepressant medication to treat depressed opioid dependents in treatment with opioid agonists. Although not all of these side effects may occur, if they do occur they may need medical attention. Using this medicine while you are pregnant may cause serious unwanted effects, including neonatal withdrawal syndrome in your newborn baby.

Short and Long-Term Effects of Methadone Treatment

When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Medicines that interact with methadone may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with methadone. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does.

  1. One of the top priorities in today’s societies should be to identify addiction-related problems and plan to control and reduce the number of addicts 1.
  2. Most cases involve patients being treated for pain with large, multiple daily doses of methadone, although cases have been reported in patients receiving doses commonly used for maintenance treatment of opioid addiction.
  3. While methadone’s half-life is long, the duration of analgesic effect after repeated dosing is 8–12 h.28 The risk of side effects, however, including respiratory depression, persists beyond this analgesic window.

Broers et al. referred to the role of methadone as a protective factor in reducing injections and common syringe use 39; similarly, Beoers et al. highlighted the role of methadone treatment in significantly reducing AIDS and hepatitis B and C among addicts 40. Dolan et al. also reported that methadone therapy (over 60 mg/day) is effective in reducing injections in addicts 41. All studies were clinical trials; Nine articles were written in English and 10 in Persian (Table 1). Contact your doctor right away if you have any changes to your heart rhythm.

Depression is a common, co-occurring mental health disorder among people who receive methadone maintenance therapy. While chronic opioid abuse can contribute to depression, methadone is unlikely to cause this when taken as an addiction treatment. Most cases involve patients being treated for pain with large, multiple daily doses of methadone, although cases have been reported in patients receiving doses commonly used for maintenance treatment of opioid addiction.